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PSA Results after Surgery-Worried

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Posted 2/27/2008 3:21 PM (GMT 0)

I am turning to this great group because I know you can help relieve my anxiety.

I keep reading from comments about a PSA of "zero" and this makes me worried.

My PSA results: .02 after 6 weeks;  .01 after 6 months;  .03 after 1 year.

I understand the concept of "ultra sensitive" and intellectually I should not be worried about these results since they are probably all in the range of statistical error. However, I do not like the trend and quite frankly, I am very worried.

I will not see my surgeon for another 8 days and so I am turning to this Group for help.

Sometimes I just curse the concept of ultra sensitive technology, but I recognize that technology (DaVinci) created a better surgery.

Should I be worried or am I just projecting and creating my own anxiety?

Thanks in advance for your help.

Ed

Posted 2/27/2008 3:31 PM (GMT 0)
Ed,

I am glad that my surgeon does not give me numbers just tells me that it is undetectable. My primary doctor has given me my blood test that he has done and my PSA on those have been .002 and .003. Your post op path report indicates the tumor was confined to the prostate so you should relax and not worry about the numbers. Make sure you let your surgeon know that you are feeling stressed with the numbers and I am sure he will explain them to you.

Tamu
Posted 2/27/2008 3:48 PM (GMT 0)
Tamu:

Thanks for the quick reply.

Question: Is your PSA .002 and .003 OR 0.02 and 0.03? I have never heard of a PSA to three decimal points!!!

I recognize that the statistical undetectable threshold is probably .05 or less but I am still very anxious.

Ed
Posted 2/27/2008 3:54 PM (GMT 0)

sween76 said...

My PSA results: .02 after 6 weeks;  .01 after 6 months;  .03 after 1 year.

Sometimes I just curse the concept of ultra sensitive technology, but I recognize that technology (DaVinci) created a better surgery.

Should I be worried or am I just projecting and creating my own anxiety?

Thanks in advance for your help.

Ed

I understand your anxiety, Ed.  In PSA testing, and sometimes in the PSA lingo we use on the forum, it can be confusing to see numbers other than zero on your test results. It would be more accurate for us to write "undetectable" or less than 0.1 rather than "zero", but "zero" understandably sounds much more definitive.

Most urologists use the 0.1 ng/mL cutoff below which the PSA is considered negative.  The ultrasensitive PSA test, as you know, measures to the neareset hundredth of a nanogram (0.01), so you may see results of 0.02 and 0.03 as in your case. 

For the standard PSA, which measures to the nearest tenth of a nanogram (0.1), the lowest detectable value is 0.1 ng/mL, so anything below this, including your test values, cannot be measured.

I personally chose to have the standard PSA test for my followup testing, because it still measures accurately enough to catch any cancer recurrence, but eliminates the "noise" of values below 0.1 that can be measured, but that are insignificant.

I sleep better not knowing any numbers other than <0.1 ng/mL for my followup PSAs.

Take care and hang in there...Tim

Posted 2/27/2008 6:48 PM (GMT 0)
Hi Sween76,
I am with Tamu and TimG. While there may be some usable value to anything under 0.1, my oncologist doesn't like to worry his patients. The adrenal gland can emit some PSA that is measurable with the ultrasensitive test, and it has no bearing on the disease progression. I call <0.1 a big zero. And will gladly take it. And I have peace of mind. There is a call to beware if in one test it's 0.01 then 0.05, then again at 0.09 in consecutive tests. But you are still considered below the standard in all three. And additional treatment would not begin until you went to 0.1 in most cases after three tests. (my case may be the exception). I wouldn't let it bother you. Good luck, don't sweat it. Stay Positive!

Tony
Posted 2/27/2008 10:50 PM (GMT 0)
I sweat out each of my PSA tests so am very glad my doc just tells me I'm a "big fat zero" each time. I don't worry about the small stuff that I can't control so I don't even know if my test is regular or ultra-sensitive. When my PSA went up to 7.1 and my family doc sent me for a biopsy he told me "I'll tell you when to start worrying." Good advice...

Jim
Posted 2/27/2008 10:54 PM (GMT 0)

You have been given good advice.  The only reason I am even commenting is that I had an appointment with my doctor yesterday.  I voiced some concern because my psa was tested at a different lab the last two times (90 days apart) and showed an increase from >.002 to < .02.  It had already been explained that had to do with how the different labs reported results.

My doctor said quite firmly that labs should stop playing with the numbers and indicate to the patient/doctor if it was  or was not dectectable.  He said mine was not detectable and  he would see me in six months, only to continue work with my ED.

He also prescribed bi-mix for me.  This is another story that I will talk about later.

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